Initial experience with miniature axial flow ventricular assist devices for postcardiotomy heart failure Michael J Jurmann, MD, Henryk Siniawski, MD,

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Presentation transcript:

Initial experience with miniature axial flow ventricular assist devices for postcardiotomy heart failure Michael J Jurmann, MD, Henryk Siniawski, MD, Michael Erb, MD, Thorsten Drews, MD, Roland Hetzer, MD, PhD The Annals of Thoracic Surgery Volume 77, Issue 5, Pages 1642-1647 (May 2004) DOI: 10.1016/j.athoracsur.2003.10.013

Fig 1 Impella Recover left ventricular assist device. The tip of the blood pump bears the inlet cannula, above which the impeller and the electrical motor are situated. The thin driveline is exterritorized and connected to the external control console and the purger. The Annals of Thoracic Surgery 2004 77, 1642-1647DOI: (10.1016/j.athoracsur.2003.10.013)

Fig 2 (A) Situs of an Impella Recover intracardiac LVAD after implantation in a patient following triple aortocoronary saphenous vein and left ITA bypass grafting. The blood pump was advanced into the LV in a retrograde fashion via a prosthetic graft, which had been anastomosed to the ascending (Asc.) aorta. The patient's head is oriented to the right. (B) Intracardiac position of the Recover LVAD as demonstrated by intraoperative transesophageal echocardiography. (ITA = internal thoracic artery; LV = left ventricle; LVAD = left ventricular assist device.) The Annals of Thoracic Surgery 2004 77, 1642-1647DOI: (10.1016/j.athoracsur.2003.10.013)

Fig 3 Combined use of the Impella Recover LVAD and RVAD in a patient with biventricular graft failure after cardiac transplantation. The intraoperative situs illustrates the remarkably compact implants of the smallest BVAD available at this time. The patient's head is oriented to the left. (BVAD = biventricular assist device; LVAD = left VAD; RVAD = right VAD.) The Annals of Thoracic Surgery 2004 77, 1642-1647DOI: (10.1016/j.athoracsur.2003.10.013)

Fig 4 Course of LVEF in six patients before, during, and after coronary artery bypass grafting and temporary circulatory support with the Recover LVAD. Four patients were weaned from the LVAD and two remain long-term survivors. (LVAD = left ventricular assist device; LVEF = left ventricular ejection fraction; preop = preoperative; postop = postoperative.) The Annals of Thoracic Surgery 2004 77, 1642-1647DOI: (10.1016/j.athoracsur.2003.10.013)

Fig 5 Serial average values for plasma free hemoglobin (hb) [g/100 mL] in six patients undergoing coronary artery bypass grafting and temporary support with the Recover LVAD. Data are presented as the mean + one standard deviation. (LVAD = left ventricular assist device; op = day of operation; pod = postoperative day.) The Annals of Thoracic Surgery 2004 77, 1642-1647DOI: (10.1016/j.athoracsur.2003.10.013)

Fig 6 Average daily platelet count [1012/L] of six patients receiving coronary artery bypass grafting and temporary support with the Recover LVAD. Data are presented as the mean + one standard deviation. (LVAD = left ventricular assist device; op=day of operation; pod = postoperative day; preop = preoperative.) The Annals of Thoracic Surgery 2004 77, 1642-1647DOI: (10.1016/j.athoracsur.2003.10.013)